Cigna has teamed up with Integrated Independent Physicians Network in Florida for an accountable care organization model that rewards doctors for having a healthier population and saving money.
Cigna said it compensates the IP Network for the medical care coordination services it provides. Also, the group may be rewarded through a "pay for value" structure if it meets targets for improving quality and lowering medical costs.
Cigna's ACO with the IP Network in Florida is among 16 in that state and 150 Cigna Collaborative Care arrangements with large physician groups in 29 states.
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The connection between doctors and payers lower costs through collaborating on closing gaps in care, such as missed health screenings and prescription refills, educating individuals about immediate care available outside of the use of the emergency room, increasing preventive health visits, and improving follow-up care for patients transitioning from hospital to home, according to Cigna.
It works by having registered nurse clinical care coordinators, employed by the IP Network, aligned with a team of Cigna case managers. The physician-led team works with patients who have chronic conditions and other health challenges get follow up care or screenings, identify potential complications and prevent chronic conditions from worsening.
They can also help individuals schedule appointments, provide health education and refer people to Cigna's clinical support programs available through their employer's health plan.
IP Network in Orlando has about 1,300 specialty physicians in seven counties throughout central Florida.
"Transitioning to a value-based reimbursement model rewards doctors for results and focuses on prevention, wellness, health improvement and care coordination," said Michael Howell, MD, Cigna's senior medical director in Florida.